Exam 18: Surgical Management of Clefts and Velopharyngeal Insufficiencyincompetence VPI

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What procedure is used for aligning the maxillary segments prior to formal surgery for unilateral and bilateral clefts?

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Why is palate surgery more difficult than lip surgery?

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Which of the following is true about VPI?

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Match the letter of the answer with each item.
Can be used as a primary palate repair, or as a secondary procedure
Tennison-Randall
Used for very small velopharyngeal openings
Von Langenbeck procedure
Used to repair a cleft lip
Tongue flap
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Can be used as a primary palate repair, or as a secondary procedure
Tennison-Randall
Used for very small velopharyngeal openings
Von Langenbeck procedure
Used to repair a cleft lip
Tongue flap
Uses the palatopharyngeus muscles
Cheiloplasty
Often needs to be done before a pharyngeal flap
Two-flap palatoplasty
Done after facial growth has completed, to correct skeletal malocclusion
Pharyngeal augmentation
Used to close a fistula
Tonsillectomy
Rarely has a negative effect on speech; may correct hyponasality or cul-de-sac resonance
Adenoidectomy
Best procedure for a large midline velopharyngeal opening
Sphincter pharyngoplasty
Can improve the airway and articulation, but may cause hypernasality
Furlow Z-plasty
Is usually contraindicated when there is a history of cleft palate
Pharyngoplasty
General term for a surgery to correct VPI?
Intravelar veloplasty
General term for lip repair
Pharyngeal flap
Best procedure for a "bowtie" type of velopharyngeal gap with lateral gaps
Le Fort I maxillary advancement
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With regard to the timing of cleft lip repair, the "rule of 10s" includes which of the following?

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The earliest that a pharyngoplasty is usually done is at what age?

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What is the location of an "intentional" fistula?

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When is a cheiloplasty usually performed?

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What is a common surgical procedure for correction of velopharyngeal insufficiency?

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Patients with a history of cleft palate and surgical repair often demonstrate which of the following?

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Which of the following is not a major factor that determines the success of a pharyngeal flap in correction of VPI?

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Why is the alveolar arch cleft left unrepaired until the age of 6 or 7?

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